Obamacare Is Open: What To Watch On Day One

At the U.S. Department of Health and Human Services Monday, Kathleen Sebelius compared the launch of Obamacare to the launch of an Apple product: highly public and eagerly anticipated but with inevitable glitches that can be ironed out without spoiling the whole show.

“About 10 days go, I got the prompt that the operating system had changed and did I want to upgrade to the new operating system and so I did it,” Sebelius said. “Then about five days after that, I got the second prompt saying there’s a little problem with the system and now we have a new, new upgrade and why don’t you upgrade your upgrade.”

“And I thought, okay, this is Apple. It has a few more resources than we have to roll out technology. No one is calling on Apple to not sell devices or to get out of the business because the whole thing is a failure. It was just a reminder that we’re likely to have some glitches. We will fix them and move on. Hopefully people will give us the same slack that they give Apple.”

Here’s where things stand as of Tuesday when Obamacare goes live for the first time– and what the administration expects on the law’s first day.

The law’s health insurance marketplaces opened across the nation. It wasn’t a flawless launch. The small-business section of the 36 marketplaces being run by HHS won’t be fully ready until next month. Some state-run marketplaces, such as the District of Columbia’s, won’t be fully opened on the first day. Reports of glitches were frequent in the run-up to the launch, and now the marketplaces will have to perform for a live audience.

HHS officials walked reporters through the process Monday; a video demonstration is available here. The experience felt similar to filing one’s taxes on TurboTax and could be completed within an hour. Consumers need basic information (household size, expected 2014 income). After entering some initial information, they’ll find out what financial help is available to them and what their health plan options are.

Though there still might be a learning curve — health insurance is inevitably complicated — administration officials stressed that the shopping experience is the result of input from hundreds of average Americans. “Nothing like this has ever existed before,” Sebelius said.

The Obama administration, for its part, isn’t setting high expectations for the launch date. At a briefing with reporters last week, senior administration officials showed off a line graph of how enrollment went in Massachusetts when it implemented its 2006 health care reform law.

The bottom line? Most people signed up at the last minute. Under Obamacare, the last minute would be Dec. 15. That’s the last day that people can sign up for coverage and still have it start on Jan. 1, 2014.

So officials don’t expect a rush of people to come to the marketplaces on the first day. In fact, administration officials portrayed Oct. 1 as the launch date for a two-and-a-half-month public relations push to get people enrolled.

“What you’ll notice starting (Tuesday) is a turning up the volume on our educational efforts since now people finally have something to do,” Sebelius said.

That outreach includes a vigorous public outreach campaign, which will range from television ads to on-the-ground efforts by grassroots groups. They’ll be competing with conservative groups that have been actively discouraging people from signing up for health coverage under the law.

But by the end of the day Tuesday, what will success for the Obama administration look like? If everything is still up and running, that’s a win, HHS officials told reporters Monday.

“Tomorrow is the beginning of a sustained six-month conversation that we are going to continue to ramp up,” an HHS official told reporters Monday. “In terms of success, I think at the end of the day tomorrow, our systems are online, and people are able to access them.”

Over the next year, the White House hopes to enroll seven million people — including 2.7 million young and healthy people — to sign up for coverage. And the clock started ticking on Tuesday.